ADVANCE HEALTH CARE DIRECTIVES
FOR MENTAL HEALTH

A Trainer’s Manual

 

PAI Publication #5407.01 – December 2005

 

 

Table of Contents

 

I. INTRODUCTION.. 1

II. ADVANCE DIRECTIVES. 1

a.   What is an Advance Directive for Health Care?. 1

b.  Advance Directives are recognized in both state and federal law. 1

c.   Advance Health Care Directives have three primary components: 2

III. MAKING AN ADVANCE DIRECTIVE. 3

a.   Who can make an Advance Directive?. 3

b.  What is Capacity?. 3

c.   How can a person prove he/she has capacity?. 4

d.  Free will 4

IV. WHEN AN ADVANCE DIRECTIVE GOES INTO EFFECT. 5

V. HEALTH CARE AGENTS. 5

a.   Appointing an Agent 6

b.  Limiting the Agent’s Power 6

c.   When does the Agent’s power go into effect?. 7

d.  Who cannot act as a Health Care Agent?. 7

e.   Information for Health Care Agents. 8

f.   Appointing a surrogate. 8

VI. NOMINATION OF A CONSERVATOR.. 9

VII. INDIVIDUAL HEALTH CARE INSTRUCTIONS. 10

a.   Treatment Facilities and Notification of Others. 11

b.  Primary Physician. 12

c.   Emergency Interventions. 13

d.  Psychiatric Medications. 13

e.   Electro-Convulsive Therapy (ECT) 14

VIII. GENERAL POWER OF ATTORNEY.. 16

IX. SIGNING AND WITNESSING THE ADVANCE DIRECTIVE. 17

a.   Witnessing the Advance Directive. 17

b.  Who cannot be a witness?. 17

c.   Witnesses or Notary Public?. 18

d.  Special Witness Requirements. 18

X. DISTRIBUTION OF THE ADVANCE DIRECTIVE. 19

XI. REVOKING OR CHANGING AN ADVANCE DIRECTIVE. 20

a.   Revocation. 20

b.  Changing an Advance Directive. 20

XII. PROBLEM SOLVING.. 21

a.   What if a facility refuses to honor an Advance Directive on the basis that the person created the Advance Directive did not have capacity to make one?. 21

b.  What if a facility does not permit the Agent to consent to or refuse treatment?. 22

c.   What if a facility does not consider the person’s Advance Directive in a psychiatric “emergency”?.